Cataract surgery questions

I am planning to have cataract surgery on my eyes.

I have been nearsighted since about age 14 (need glasses for distance
seeing) and am now 57, but for about 4 years around age 48-52 my eyes got
better and I stopped wearing my glasses. They then went back to being
nearsighted and I also started needing reading glasses for close-up seeing.

I was told that I had cataracts starting about 10 years ago but it is only
in the past two years that it has become a problem with driving at night and
any sort of glaring lights shining in my eyes.

Now my eyes seem to be perpetually smudgy as well (like looking through
dirty glasses) both near and far. One eye is definitely worse than the
other.

When I go to have the surgery, can I ask for lenses that will allow me to
see clearly at a distance without glasses or will my previous
nearsightedness make that choice impossible? I would prefer to be able to
see at a distance without glasses and use glasses for close-up work if that
is possible.

Is it a possibility to have one eye set for clear vision at a distance and
one set for close-up vision (without glasses) or would that tend to cause
too much eye strain?

At my age (57) is it likely that whatever lenses I am fitted with now will
eventually become incorrect as I age and my eyes change shape, assuming I
live to be 75+? Do people have multiple cataract surgeries as they grow
older if the fitted lenses become incorrect?

Is it dangerous to rub your eyes with cataract lenses fitted in your eyes
(after the operation is fully healed)? Could that damage or wrinkle the
lenses and impair your vision?

Finally, I am very squeamish about my eyes and could never adapt to contact
lenses when younger. The thought of someone cutting into my eye and doing
things in there creates a lot of anxiety for me. What can be done to make
sure that I don't twitch or move during the actual surgery and mess up the
surgeon's work?

Both my mom and her twin sister had early cataracts in their 40s and
underwent the old cataract operations done back in the sixties which left
them bedridden for many days and having to wear those coke-bottle lens
glasses for the rest of their lives. That may be where I get some of my
anxiety, but whatever the cause, it worries me that I could do something to
screw up the operation. I figure that the second eye will be easier after I
get through the first operation.

Thanks a lot for any advice.

On Wed, 24 Oct 2007 10:42:57 GMT, "Luis Ortega" <(E-Mail Removed)>
wrote:

>I am planning to have cataract surgery on my eyes.

I had cataract surgery about a year ago, one eye in November and the
other six weeks later. I'm still thrilled with the results. For a half
century I wore eyeglasses for everything. Now I don't need them
(except for reading). I drive legally without glasses; the DMV
removed their "corrective lenses" restriction. Wow!

>When I go to have the surgery, can I ask for lenses that will allow me to
>see clearly at a distance without glasses or will my previous
>nearsightedness make that choice impossible? I would prefer to be able to
>see at a distance without glasses and use glasses for close-up work if that
>is possible.

My situation, too. My eye surgeon (I'm not a medical professional) set
me up for distance vision and glasses for close-up without my even
asking.

>Is it a possibility to have one eye set for clear vision at a distance and
>one set for close-up vision (without glasses) or would that tend to cause
>too much eye strain?

After reading and talking to my surgeon I got the impression that one
distance eye/one near eye was possible but tricky to adjust to. I
declined.

>Is it dangerous to rub your eyes with cataract lenses fitted in your eyes
>(after the operation is fully healed)? Could that damage or wrinkle the
>lenses and impair your vision?

I understand that after healing, "normal" eye rubbing is OK. I rub my
eyes from time to time. They're OK.

>Finally, I am very squeamish about my eyes and could never adapt to contact
>lenses when younger. The thought of someone cutting into my eye and doing
>things in there creates a lot of anxiety for me. What can be done to make
>sure that I don't twitch or move during the actual surgery and mess up the
>surgeon's work?

Right. Pre-surgery anxiety. Of course, I had it, too. The best comment
I can think of is: if I had a choice now to have another cataract
operation or to go to the dentist, I wouldn't hesitate to avoid the
dentist. The eye surgery would be my hands-down choice.

I think the risk of you doing something to mess up the operation is
small. Before my operation, the nurse washed around my eye with
topical antiseptics and painkillers. They also gave me an IV for
sedatives (and whatever). An anesthesiologist was part of the surgery.

During the surgery, they propped the eye open with some kind of small
wire frame. I really couldn't see it and, more importantly, it was
not uncomfortable. And because of the local analgesics, I could feel
NOTHING. I repeat, NOTHING at all, including whatever the doctors were
doing tinkering around in there.

If you think your anxiety is severe, let them know. They'll just pump
more happy-juice into your arm.

>Both my mom and her twin sister had early cataracts in their 40s and
>underwent the old cataract operations done back in the sixties which left
>them bedridden for many days.

I had my surgery in the morning. That evening my wife and I went out
to dinner to celebrate. And I went back to work the next day.
Bed-ridden? Hah!

My biggest restrictions after surgery were not to lift anything over
30 lbs. for a week (An excuse to skip yard work. Yay!) and not to get
my surged eye wet for a week (Big deal!).

>I figure that the second eye will be easier after I
>get through the first operation.

You got that right. And I had fun in the in-between time closing one
eye and looking alternately at life through the new good eye or the
old bad eye. Two different worlds.

In summary, cataract surgery? Try it, you'll like it.

--
Regards,
Dan

In article <RkFTi.30$(E-Mail Removed)>,
"Luis Ortega" <(E-Mail Removed)> wrote:


> When I go to have the surgery, can I ask for lenses that will allow me to
> see clearly at a distance without glasses or will my previous
> nearsightedness make that choice impossible? I would prefer to be able to
> see at a distance without glasses and use glasses for close-up work if that
> is possible.

That is what I chose, and I'm happy with it. Note that there is some
margin of error in the measurements they using for setting the lens
power, and it could be off enough that you will have to wear glasses for
best vision at *any* distance.

> Is it a possibility to have one eye set for clear vision at a distance and
> one set for close-up vision (without glasses)

This called "monovision", and many people like it. Others can't get
used to it. You will also lose some of your depth perception. It is
usually done with contacts, so those people can just get new contacts if
they can't adapt to it. If you have this done surgically you are stuck
with it, and will have to wear glasses to undo it.

> At my age (57) is it likely that whatever lenses I am fitted with now will
> eventually become incorrect as I age and my eyes change shape, assuming I
> live to be 75+?

No, eyes don't usually change in that age range.


> Do people have multiple cataract surgeries as they grow
> older if the fitted lenses become incorrect?


No, they do what everybody else does, get new glasses. If your vision
is correctable, it is unlikely the doctor would do a second surgery.


> Is it dangerous to rub your eyes with cataract lenses fitted in your eyes
> (after the operation is fully healed)? Could that damage or wrinkle the
> lenses and impair your vision?

Once everything heals and scar tissue forms, they are in pretty securely.


> Finally, I am very squeamish about my eyes and could never adapt to contact
> lenses when younger. The thought of someone cutting into my eye and doing
> things in there creates a lot of anxiety for me. What can be done to make
> sure that I don't twitch or move during the actual surgery and mess up the
> surgeon's work?

I had no problems with my first cataract surgery. However, they do not
use that type of anesthesia anymore due to risks. My eye was completely
immobile and blind. Now they use a topical anesthetic that leaves
vision and feeling, but there is no pain. I did very poorly on my
second cataract surgery. I was unable to lie still, I was literally
shaking with fear. The doctor didn't believe in tranquilizers. I had a
much more difficult and longer eye surgery a couple of years later. I
was given sufficient drugs so that I had no problems, even though it was
still a topical anesthetic, I was completely awake and could see. It
would be wise to discuss this with your doctor and also find out who is
in charge of anesthesia. For my cataract surgery, it was a nurse. For
my later surgery, I talked to the anesthesiologist and gave my story.
Even though it was a nurse who administered the anesthesia, it was
according the doctor's orders.


> Both my mom and her twin sister had early cataracts in their 40s and
> underwent the old cataract operations done back in the sixties which left
> them bedridden for many days and having to wear those coke-bottle lens
> glasses for the rest of their lives. That may be where I get some of my
> anxiety, but whatever the cause, it worries me that I could do something to
> screw up the operation. I figure that the second eye will be easier after I
> get through the first operation.

Things are a lot better now. It's about 2 hours from checkin to
checkout. My wife and I went out to lunch after the first one. I was
perfectly fine the next day, and worked from home.

As a former cataract surgery patient, I have some further advice. 1)
Choose an experienced cataract/refractive surgeon. 2) If you have
astigmatism, see if it can be corrected at the time of surgery. 3)
Get aspheric monofocal lenses. 4) Do not have surgery with a doctor
who still uses needle anesthesia ("blocks"). Needle anesthesia
carries small but very serious risks, including permanent vision loss
and eye muscle damage. Most cataract surgeons today use topical
anesthesia (eye drops), which is much safer. And you can leave the
surgery center without an eye patch.

Best of luck. I predict that you will be pleased with your results.

Thanks, everyone for your informative and supportive replies.
I will report back on my experience when I have my operations.

"Luis Ortega" <(E-Mail Removed)> wrote in message
news:RkFTi.30$(E-Mail Removed)...
>I am planning to have cataract surgery on my eyes.
>
> I have been nearsighted since about age 14 (need glasses for distance
> seeing) and am now 57, but for about 4 years around age 48-52 my eyes got
> better and I stopped wearing my glasses. They then went back to being
> nearsighted and I also started needing reading glasses for close-up
> seeing.
>
> I was told that I had cataracts starting about 10 years ago but it is only
> in the past two years that it has become a problem with driving at night
> and any sort of glaring lights shining in my eyes.
>
> Now my eyes seem to be perpetually smudgy as well (like looking through
> dirty glasses) both near and far. One eye is definitely worse than the
> other.
>
> When I go to have the surgery, can I ask for lenses that will allow me to
> see clearly at a distance without glasses or will my previous
> nearsightedness make that choice impossible? I would prefer to be able to
> see at a distance without glasses and use glasses for close-up work if
> that is possible.
>
> Is it a possibility to have one eye set for clear vision at a distance and
> one set for close-up vision (without glasses) or would that tend to cause
> too much eye strain?
>
> At my age (57) is it likely that whatever lenses I am fitted with now will
> eventually become incorrect as I age and my eyes change shape, assuming I
> live to be 75+? Do people have multiple cataract surgeries as they grow
> older if the fitted lenses become incorrect?
>
> Is it dangerous to rub your eyes with cataract lenses fitted in your eyes
> (after the operation is fully healed)? Could that damage or wrinkle the
> lenses and impair your vision?
>
> Finally, I am very squeamish about my eyes and could never adapt to
> contact lenses when younger. The thought of someone cutting into my eye
> and doing things in there creates a lot of anxiety for me. What can be
> done to make sure that I don't twitch or move during the actual surgery
> and mess up the surgeon's work?
>
> Both my mom and her twin sister had early cataracts in their 40s and
> underwent the old cataract operations done back in the sixties which left
> them bedridden for many days and having to wear those coke-bottle lens
> glasses for the rest of their lives. That may be where I get some of my
> anxiety, but whatever the cause, it worries me that I could do something
> to screw up the operation. I figure that the second eye will be easier
> after I get through the first operation.
>
> Thanks a lot for any advice.
>

A little late to the thread here. I'm in the same boat as the original
poster. According to my eye doc, I was born with cataracts, but now
that I'm aging (53), the problem's compounded by the natural aging of
my lenses.

The doc said that it's possible for me to go without glasses if in
addition to having the cataract surgery I have laser surgery (PRK?),
and that it's possible to have both procedures can be done at the same
time. The caveat she gave is that there is pain after the laser
surgery and described it as a "rug burn". Some accounts from people on
the web who have had this surgery describe it as terribly painful
afterwards, and suggest the need for heavy pain medication for more
than a day or two.

Any experience with that here?


On Oct 25, 6:29 am, "Luis Ortega" <lort...@ntlworld.com> wrote:
> Thanks, everyone for your informative and supportive replies.
> I will report back on my experience when I have my operations.
>
> "Luis Ortega" <lort...@ntlworld.com> wrote in message
>
> news:RkFTi.30$(E-Mail Removed)...
>
> >I am planning to have cataract surgery on my eyes.
>
> > I have been nearsighted since about age 14 (need glasses for distance
> > seeing) and am now 57, but for about 4 years around age 48-52 my eyes got
> > better and I stopped wearing my glasses. They then went back to being
> > nearsighted and I also started needing reading glasses for close-up
> > seeing.
>
> > I was told that I had cataracts starting about 10 years ago but it is only
> > in the past two years that it has become a problem with driving at night
> > and any sort of glaring lights shining in my eyes.
>
> > Now my eyes seem to be perpetually smudgy as well (like looking through
> > dirty glasses) both near and far. One eye is definitely worse than the
> > other.
>
> > When I go to have the surgery, can I ask for lenses that will allow me to
> > see clearly at a distance without glasses or will my previous
> > nearsightedness make that choice impossible? I would prefer to be able to
> > see at a distance without glasses and use glasses for close-up work if
> > that is possible.
>
> > Is it a possibility to have one eye set for clear vision at a distance and
> > one set for close-up vision (without glasses) or would that tend to cause
> > too much eye strain?
>
> > At my age (57) is it likely that whatever lenses I am fitted with now will
> > eventually become incorrect as I age and my eyes change shape, assuming I
> > live to be 75+? Do people have multiple cataract surgeries as they grow
> > older if the fitted lenses become incorrect?
>
> > Is it dangerous to rub your eyes with cataract lenses fitted in your eyes
> > (after the operation is fully healed)? Could that damage or wrinkle the
> > lenses and impair your vision?
>
> > Finally, I am very squeamish about my eyes and could never adapt to
> > contact lenses when younger. The thought of someone cutting into my eye
> > and doing things in there creates a lot of anxiety for me. What can be
> > done to make sure that I don't twitch or move during the actual surgery
> > and mess up the surgeon's work?
>
> > Both my mom and her twin sister had early cataracts in their 40s and
> > underwent the old cataract operations done back in the sixties which left
> > them bedridden for many days and having to wear those coke-bottle lens
> > glasses for the rest of their lives. That may be where I get some of my
> > anxiety, but whatever the cause, it worries me that I could do something
> > to screw up the operation. I figure that the second eye will be easier
> > after I get through the first operation.
>
> > Thanks a lot for any advice.

Not sure that this is a "huge" prescription:

OD-SPH: -1.25
OD-CYL: -1.25
OD-AXIS: 170
OD-ADD: +1.75
OS-SPH: 0
OS-CYL: -3.50
OS-AXIS: 15
OS-ADD: +1.75

When you say the procedures are "approximate", I take that to mean
that they commonly correct the cataract first, then see what ther
result is before deciding to do anything else. Is this correct?

Here's one detail you don't know: My eye doc isn't a surgeon, she's an
O.D., and she suggested that it *might* be possible to combine the
cataract surgery with laser, but I would need to check with the doc
who does the surgery. And for my part, right now I'm just gathering
all of the info I can about the procedure before talking to surgeons,
understanding these data points are coming from anonymous people on
usenet.

The other detail I left out is that when I had this discussion with
the doc I was stressing over the whole thing and might have missed
something in the conversation. Remember the Far Side cartoon where the
owner is speaking say to the dog "Okay, Ginger! I've had it! You stay
out of the garbage! Understand, Ginger? Stay out of the garbage, or
else!", but the dog hears "blah blah GINGER blah blah blah blah blah
blah blah blah GINGER blah blah blah blah blah..."? I was hearing
"blah blah blah CUT OPEN YOUR EYEBALL WHILE YOU ARE AWAKE AND WATCHING
BUT DRUGGED blah blah blah ".


On Nov 1, 10:06 am, "Mike Tyner" <mty...@mindspring.com> wrote:
> "Wiz" <ourcomputer...@gmail.com> wrote
>
> > The doc said that it's possible for me to go without glasses if in
> > addition to having the cataract surgery I have laser surgery (PRK?),
> > and that it's possible to have both procedures can be done at the same
> > time.
>
> Two things I don't understand about that.
>
> First, is your prescription so huge or complicated that cataract surgery
> isn't enough by itself? And second, if the results of both procedures are
> somewhat approximate, are you compounding the opportunity for error by doing
> both at the same time?
>
> There are probably details that I don't know about.
>
> But even so, it's a little optimistic to say you can "go without glasses"
> after cataract surgery. Was she talking about a multifocal implant?
> Monovision? How would you avoid reading glasses?
>
> -MT

In article <(E-Mail Removed) .com>,
Wiz <(E-Mail Removed)> wrote:

> Not sure that this is a "huge" prescription:
>
> OD-SPH: -1.25
> OD-CYL: -1.25
> OD-AXIS: 170
> OD-ADD: +1.75
> OS-SPH: 0
> OS-CYL: -3.50
> OS-AXIS: 15
> OS-ADD: +1.75


> who does the surgery. And for my part, right now I'm just gathering
> all of the info I can about the procedure before talking to surgeons,
> understanding these data points are coming from anonymous people on
> usenet.


A very good idea, in my personal opinion. There are things in cataract
surgery that the patient can have a voice in, if they understand what to
ask for. If they don't (and many people just aren't interested), the
doctor will do what is best based on experience with most patients. I
would recommend a Google search on this group with the subject of
"cataract". Many people have contributed their own experiences with
cataract surgery over the years.

Another personal preference of mine is to avoid surgery, that's why I've
had four eye surgeries.

:-(

My choice was simple, have surgery or go blind. Cataract surgery (which
I've had in both eyes) is an example of this. It is simply not
correctable with glasses or contacts. Astigmatism (which you have a lot
of) is normally corrected with lenses. I would advise finding out
whether this additional surgery will do a better job.

Another factor is cost. If you have insurance, it will generally cover
cataract surgery but not the other. This could make a big difference in
your decision.

I support Mike's suggestion that you separate the two surgeries, if you
decide to do both at all. Cataract surgery involves some measurements
and stuff that aren't perfectly predictable. I can't say that I
understand them (I'm not a doctor), but you'll have to sign a form
agreeing that you understand that you may be a fulltime wearer of
glasses, despite their best efforts. If you do the surgeries
separately, the second one can correct whatever problems might be
uncovered after healing from the first one. You *will* be wearing
glasses part time, or go without seeing clearly. You can choose close,
middle or distance vision. You can't get all three, without glasses of
some sort.


> The other detail I left out is that when I had this discussion with
> the doc I was stressing over the whole thing and might have missed
> something in the conversation. Remember the Far Side cartoon where the
> owner is speaking say to the dog "Okay, Ginger! I've had it! You stay
> out of the garbage! Understand, Ginger? Stay out of the garbage, or
> else!", but the dog hears "blah blah GINGER blah blah blah blah blah
> blah blah blah GINGER blah blah blah blah blah..."? I was hearing
> "blah blah blah CUT OPEN YOUR EYEBALL WHILE YOU ARE AWAKE AND WATCHING
> BUT DRUGGED blah blah blah ".


You left out the last two panels in the strip. In the third, the owner
is lecturing his cat. In the fourth, what the cat hears, "blah blah
blah".

> On Nov 1, 10:06 am, "Mike Tyner" <mty...@mindspring.com> wrote:
> > "Wiz" <ourcomputer...@gmail.com> wrote
> >
> > > The doc said that it's possible for me to go without glasses if in
> > > addition to having the cataract surgery I have laser surgery (PRK?),
> > > and that it's possible to have both procedures can be done at the same
> > > time.
> >
> > Two things I don't understand about that.
> >
> > First, is your prescription so huge or complicated that cataract surgery
> > isn't enough by itself? And second, if the results of both procedures are
> > somewhat approximate, are you compounding the opportunity for error by doing
> > both at the same time?
> >
> > There are probably details that I don't know about.
> >
> > But even so, it's a little optimistic to say you can "go without glasses"
> > after cataract surgery. Was she talking about a multifocal implant?
> > Monovision? How would you avoid reading glasses?
> >
> > -MT